title: Chewing sugar-free gum reduces ileus after cesarean section in nulliparous women: a randomized clinical trial.
abstract: BACKGROUND
  Gum chewing after cesarean section may stimulate bowel motility and decrease duration of postoperative ileus.
  
  
  OBJECTIVE
  The current study assessed the effect of chewing sugar-free gum on the return of bowel function, where cesarean section had been performed in nulliparous women.
  
  
  METHODS
  In a randomized clinical trial, 60 patients, scheduled for cesarean section were randomly divided in to 2 groups gum-chewing group (n = 30) and control group (n = 30) postoperatively. The patients in the gum-chewing group postoperatively chewed sugar free gum 3 times daily each time for 1 hour until discharge. The patients' demographic characteristics, duration of surgery, mean hunger time, flatus and bowel motility were compared in the two groups.
  
  
  RESULTS
  There was no significant difference between the 2 groups regarding patient demographics, intraoperative, and postoperative care. In the gum-chewing and the control group there was a significant difference in the mean postoperative interval of the first bowel movement (20.89 ± 8.8 versus 27.93 ± 9.3 hours, P = 0.004), the first feeling of hunger (10.37 ± 6.0 versus 16.33 ± 9.3 hours, P = 0.005), the first passage of flatus (25.02 ± 5.8 versus 31.08 ± 9.7 hours, P = 0.003), and the first defecation (31.17 ± 5.3versus 40.08 ± 8.8 hours, P = 0.000) respectively, which were significantly shorter in the gum-chewing group compared to those of the control group. There were no major complications in either group. All patients in the gum-chewing group tolerated it without any major complications and side effects.
  
  
  CONCLUSIONS
  The study results demonstrated that bowel motility after cesarean section in nulliparous women can be accelerated by gum chewing which is a useful, inexpensive and well-tolerated method for mothers in post-cesarean section.
authors.affiliation: Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran.
authors.forename: Farideh
authors.initials: F
authors.lastname: Mohsenzadeh Ledari
authors.forename: Shanaz
authors.initials: S
authors.lastname: Barat
authors.forename: Mouloud Agajani
authors.initials: MA
authors.lastname: Delavar
authors.forename: Seyed Zahra
authors.initials: SZ
authors.lastname: Banihosini
authors.forename: Soriya
authors.initials: S
authors.lastname: Khafri
keywords: Cesarean Section; Chewing Gum; Flatulence; Ileus; Randomized Controlled Trials as Topic